Accepted for/Published in: JMIR Serious Games
Date Submitted: Mar 2, 2023
Date Accepted: Sep 8, 2023
The Development and Pre-Implementation of a Videogame Intervention to Prevent Opioid Misuse among Older Adolescents: Formative Research.
ABSTRACT
Background:
Opioid misuse and mental disorders are highly comorbid. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious videogames offer an engaging, widely scalable method for delivering and implementing preventive interventions. Yet, there are no videogame interventions that focus on preventing opioid misuse among older adolescents and limited existing videogame interventions that address mental health.
Objective:
The aim of this study was to develop and conduct a formative evaluation of a videogame intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted the formative work in preparation for a subsequent randomized controlled trial.
Methods:
We conducted development and formative evaluation of PlaySmart in three phases (development, playtesting, and pre-implementation) through individual interviews and focus groups with multiple stakeholders (adolescents (n=103), school-based health care providers (n=51), addiction treatment providers (n=6)). PlaySmart content development was informed by health belief model, theory of planned behavior, and social cognitive theory. User-centered design principles informed approach to development and playtesting. The Exploration, Preparation, Implementation, and Sustainment (EPIS) framework informed pre-implementation activities. Thematic analysis was used to identified themes from interviews and focus groups that informed PlaySmart game content and approach to future implementation of PlaySmart.
Results:
We developed a novel videogame PlaySmart for older adolescents that addresses risk and protective factors for opioid misuse and mental health. Nine themes emerged from focus groups that informed game content. Playtesting revealed areas of the game that needed improvement which were modified for the final game. Pre-implementation focus groups identified potential barriers and facilitators to implementing PlaySmart in school settings.
Conclusions:
PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.
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